Transcript Request Form

Transcript Request Form

John Hancock University

Office of the Registrar email:

registrar@ellis.edu

.

Instructions

Return form by Email:

1.

Complete

all required () information. Allow 7-10 working days from date of receipt to process request.

registrar@ellis.edu.

Or

2.

Official

transcripts are sent to directly to students, educational institutions, employers, or other third parties.

Educational records are protected by federal law. Release requires the student’s signed authorization.

by Fax :

630-873-3487

3.

Each transcript is

$10. Payment is accepted by credit card, check, or money order. Make checks payable to

John

or

Hancock University

by mail :

4.

Be sure to include CC expiration date.

(No cash, please).Transcripts will not be issued for a student who has an

Ellis University

outstanding financial obligation to John Hancock University.

2 Mid America Plaza

Complete this form on your computer by typing in the responses using Microsoft Word or “print” the form and

5.

Suite #823ABCD

write in your response. Having difficulty completing this form? Email:

registrar@ellis.edu

Oakbrook Terrace, IL 60181

Student Information

Transcript Information

LAST Name

Number of transcripts requested

FIRST Name

When should transcript(s) be sent?

SSN

Send immediately

(7-10 working days)

(if US citizen)

Date of Birth

Hold for current semester grades

Former name

Hold for recording of degree

(if any)

Day time phone#

Address

City

State

Zip

Send “Official” Transcript(s):



Is the address or phone information above new?

Yes

No

Please provide the FULL address of the recipient, including the name of the office

or contact person (if applicable) to insure the accurate delivery of your transcript.

Academic Record Information

Name

Currently attending?

Yes

No

Addr

Degree Program

Undergraduate

Graduate

Major

City

Last date attended? (Month & year)

State

Zip

Country

Did you earn a degree?

No

Yes

Name

If yes, what month & year

Addr

Payment Information

Check

Visa

MasterCard

Amex

City

Name on Card: __________________________________

State

Zip

Country

Card #: ____________________________Exp:_________

Name

Addr

_______________________________________________

Student’s Signature

City

______________________

State

Zip

Country

Date

--------------------------------------------------------------------------------- REGISTRAR’S OFFICE USE ONLY --------------------------------------------------------------------------

Hold

Payment to Bursar

Returned

Date Stamp

Hold Cleared

Processed by

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